If the Patients’ Access to Treatments Act of 2012 passes, lower copays for patients could be the new normal.
The bill limits expensive cost-sharing requirements for several medications placed in a specialty tier.
Specific benefits include:
National coverage: PATA would provide easier access to medically-necessary treatments for Americans across the nation, instead of a patchwork of state-by-state laws. Affected patients include those with certain types of cancer like leukemia and lymphoma, multiple sclerosis, rheumatoid arthritis, psoriatic arthritis, lupus, primary immunodeficiency diseases, Parkinson’s disease, hemophilia, Crohn’s disease, and other conditions. Immediate coverage: PATA would help patients access treatments now, rather than patients having to wait for the Affordable Care Act’s caps in 2014, which would still allow out-of-pocket spending of up to $500 per month. Consumers prefer slightly higher premiums over high cost sharing: A recent study by Health Affairs found that consumers are willing to pay slightly higher premiums in order to receive better specialty drug coverage. High cost sharing is contrary to what most people want in health coverage and is counterproductive if patients cannot access medications. Widespread support: Thus far PATA is supported by the American College of Rheumatology, the Arthritis Foundation, Lupus Foundation of America, National Multiple Sclerosis Society, National Psoriasis Foundation, Crohn's and Colitis Foundation of America, Patient Services Inc., and the Spondylitis Association of America. Sources available for interview: Lawmakers, supporting organizations and patients.